The lived experience of being diagnosed and treated for lung cancer in the outpatient departments of an acute care hospital: a psychosocial phenomenological study

Abstract

Aim: The aim of this project was to research participants’ lived experiences of being diagnosed and treated for lung cancer in the outpatient departments of an acute care hospital, particularly in relation to whether they reported lung cancer related psychosocial distress and secondly to analyse whether the participants felt that they had received appropriate psychosocial care from the hospital staff. Background: Lung cancer is the leading cause of cancer death worldwide with only 12% of people diagnosed surviving for more than five years beyond their diagnosis and few surviving for more than one year (Australian Institute of Health and Welfare 2011). Consequently, receiving a lung cancer diagnosis is a source of high emotional and psychosocial distress, which research suggests, is often not detected or treated by health professionals with appropriate levels of supportive care. More research is needed to identify the barriers that exist in the outpatient setting, particularly from the patients’ perspective, which undermine best practice psychosocial care. Methods: The fundamental position of phenomenological research is that human understanding is only accessible through inner subjectivity and that each person and their understandings are inseparable from the context of their environment. This approach allows open expression and exploration of patients’ lung cancer experience within the health care context. For this study, Heidegger’s hermeneutic phenomenology has been used for its interpretive approach, as it allows the researcher to use theories, knowledge and pre-understanding when interpreting the participants’ subjective experience. Results: A very high level of unrelieved psychosocial distress and concern was expressed by some of the participants with late stage lung cancer and most participants, regardless of stage, reported ongoing fear of recurrence. Some evidence of barriers which prevent supportive care from occurring became apparent. The findings developed during the research included some simple health care approaches that practitioners can adopt in order to help reduce the psychosocial distress of this group of people. These include ensuring continuity of care, improving empathetic communications, early referral and reflection on professional attitudes. It is hoped that this research will improve understanding and empathy for lung cancer patients, so that detection and treatment of psychosocial distress can be improved.